The Curbsiders Internal Medicine Podcast #100: Cirrhosis: Initial Evaluation and Management
14 snips
Jun 18, 2018 AI Snips
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Episode notes
Use Lower ALT Cutoffs To Spot Liver Injury
- Reinterpret ALT using stricter cutoffs: about 24 U/L for females and 34 U/L for males.
- Dr. Matherly warns many labs report higher 'normal' ranges; values above these thresholds correlate with higher liver-related mortality.
Check Albumin And INR After Imaging Suggests Cirrhosis
- After imaging suggests cirrhosis, check albumin and INR to assess synthetic function and severity.
- Low albumin or prolonged INR suggests advanced disease and guides urgency of hepatology referral and transplant consideration.
Use FIB-4 To Triage Need For FibroScan Or Biopsy
- Use FIB-4 as a first-line noninvasive fibrosis screen: low rules out fibrosis, high suggests advanced fibrosis and prompts further testing.
- Dr. Matherly uses FIB-4 to decide who needs FibroScan or biopsy, noting indeterminate results limit its utility.